PCT、CRP、D-二聚体在外科重症感染中的多因素分析及影响

Multivariate Analysis and Influence of PCT,CRP and D-dimer in Surgical Severe Infection

目的:探讨外科重症感染中降钙素原(PCT)、C-反应蛋白(CRP)、D-二聚体(D-D)、白细胞计数(WBC)等多因素的影响及相关关系,联合多种指标在早期重症感染中的应用。方法:随机选取我院2018年3月—2020年2月收治的外科住院疾病的病例资料180例,按有无感染分为两组:观察组(感染组)100例,对照组(同期未感染组)80例。记录两组患者入院24h内血清PCT、CRP、D-D及WBC水平,感染组以血培养阳性判定为重症感染,进行二元Logistic回归分析判断四个指标与外科重症感染的关系。结果:观察组患者PCT、CRP、D-D、WBC较对照组明显升高,差异具有统计学意义(P<0.01);二元Logistic回归分析发现PCT、CRP、D-D是外科重症感染的重要影响因素,而WBC不是重症感染的独立因素;发生重症感染时,血清PCT、CRP、D-D水平相关分析呈正相关。结论:PCT、CRP、D-D可以协同判断外科重症感染,对临床早期判断外科感染严重程度具有重要临床意义。

Objective:To investigate the effects of multiple factors such as PCT,CRP,D-dimer(D-D),WBC and its correlation and the application of combined multiple indicators in early severe infection.Methods:180 cases of surgical inpatient diseases admitted to our hospital from March 2018 to February 2020 were randomly selected and divided into two groups according to infection or not:observation group(infection group)of 100 cases and control group(non-infection group)of 80 cases.Serum levels of PCT,CRP,D-D and WBC in the two groups were recorded within 24 hours upon admission.Positive blood culture was determined as severe infection in the infection group,and binary Logistic regression analysis was performed to determine the relationship between the four indicators and surgical severe infection.Results:PCT,CRP,D-D and WBC in the observation group were significantly higher than those in the control group(P<0.01).The binary Logistic regression analysis found that PCT,CRP and D-D were important influencing factors of severe surgical infection,while WBC was not an independent factor of severe surgical infection.During severe infection,the correlation of serum PCT,CRP,D-D level was positive.Conclusion:PCT,CRP and D-D can be used to determine the severity of severe surgical infection,which has important clinical significance for early diagnosis of surgical infection.